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Cost of Prostate Cancer Surgery Varies Widely

Fees have no reflection on quality, researchers say

WebMD News from HealthDay

By Amy Norton

HealthDay Reporter

THURSDAY, June 19, 2014 (HealthDay News) -- For an uninsured man with prostate cancer, the price of surgery could range from $10,000 to $135,000, depending on the hospital, a U.S. study finds.

What's more, that wide range in charges -- a 13-fold difference -- has nothing to do with quality, researchers said.

"Consumers are used to higher prices meaning higher quality. But that's not true in medicine," said Dr. Bradley Erickson, the senior researcher on the study. "Prices are not attached to any kind of quality information."

What does determine hospital charges for prostate cancer surgery? "We really don't know," said Erickson, an assistant professor of urology at the University of Iowa in Iowa City.

What's clear, Erickson said, is that a man with no health insurance -- or insurance with high copays -- would have a tough time "shopping" for the best hospital for prostate cancer surgery.

For the study, recently published in the journal Urology, one of Erickson's colleagues pretended to be an uninsured man in need of prostate cancer surgery. He called 100 American hospitals, following the same "script" each time: He was an otherwise healthy man with the means to pay out-of-pocket, and he wanted an estimate of the total charge for surgery -- hospital and surgeon fees included.

Thirty percent of hospitals said they couldn't offer an estimate. Among the rest, the price ranged from $10,100 to $135,000 -- though only three hospitals were willing to put a quote in writing.

The average price was almost $35,000, more than twice the Medicare reimbursement, the researchers said.

Geography mattered. Hospitals in the Northeast quoted higher prices, on average, than hospitals in the South -- about $40,800 versus $30,300, Erickson said.

But in other ways, there was little rhyme or reason. Big-city hospitals, for example, charged no more than those in small cities, on average. And there was no relationship between hospital charges and their ranking by U.S. News and World Report, which publishes a list of the nation's "best" hospitals.

Experts who reviewed the study weren't surprised.

Other U.S. studies have shown wide-ranging prices for health care, said Dr. Ezekiel Emanuel, chair of medical ethics and health policy at the University of Pennsylvania in Philadelphia.

He pointed to a study last year -- by the same researchers -- showing that the price of hip-replacement surgeries at U.S. hospitals ranged from roughly $11,000 to $126,000.

There are some reasons that hospital charges could legitimately vary. For example, their costs for equipment differ to some degree, Emanuel said.

"But mostly, it's a mystery," he said. "I don't think the hospitals even know why they charge what they charge."

The American Hospital Association declined a request to comment on the study.

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